Session SA2.4

Evaluation of the Spatial Changes of the Coronary Morphology Due to Stent Implantation with 3D Angiography

T Ungvári, J Sánta, Z Béres, B Tar,
P Sánta, P Lugosi, Z Koszegi*

Jósa András Hospital
Debrece, Hungary

3-dimensional (3D) geometry of the coronary artery often changes due to stent implantation. Based on different observations the degree of the change can have an effect on the clinical outcome due to the altered segment curve by the implanted stent. In our investigation we analyzed the effect of stent on the 3D geometry in each heart-cycle phase. At the site of implantation the degree of decrease in the coronary curve were measured, and the correlation between the original curve and the change of the curve were determined. The effect of 17 Coroflex Blue (B. Braun) stents implantation (3.07±0.33 mm in diameter and 17.64±4.42 mm in length) in 17 patients was analyzed. During angiography 3D reconstruction of the intervened coronary-segment was performed by IC3D software integrated into an Axiom Artis (Siemens) roentgen device. The next optimal projection (NOP) was defined in order to minimize the foreshortening of the target segment. The curve of the segment was characterized on the 3D reconstruction installed into the NOP, measuring the distance between the line superimposed onto the midline of the stented segment (arch) and the distance of the end-points of the stented segment (chord) before an after the intervention. The bigger the curve of the stented segment was the bigger this arch/chord ratio became. The difference in the ratio of arch/chord before and after the stenting showed significant correlation both at end-diastolic and end-systolic analysis with the start-off arch/chord ratio, but the diastolic correlation was slightly higher (r=0.94, p=2x10-8 and r=0.90, p=6x10-7, respectively). We have experienced more than 10% growth in change of the curve at higher than 1.15 start-off arch/chord ratio. In the intervened coronary segment the change of the spatial morphology depending on the start-off curve even after flexible stent implantation. The degree can be estimated with 3D measurements and can be taken into consideration when defining the appropriate stent parameters.

(Abstract Control Number: 215)